Annie Catherine Clark, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

0701012434 Issued in VA

Practice address

220 Clay Dr
Pounding Mill, VA 24637-4320

Phone

(276) 963-3606

NPI assigned

Apr 24, 2023

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Highlands Community Services 30 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Highlands Community Services

  • Community/Behavioral Health Agency
  • Abingdon, VA
  • NPI 1396774147

  VA

  Medicare reassignment Care Compare group NPD
• Family Preservation Services LLC

  • Community/Behavioral Health Agency
  • Roanoke, VA
  • NPI 1093891335
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1682294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682294400000",
    "number": "1942997572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 CLAY DR",
            "city": "POUNDING MILL",
            "state": "VA",
            "postal_code": "246374320",
            "telephone_number": "276-963-3606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 CLAY DR",
            "city": "POUNDING MILL",
            "state": "VA",
            "postal_code": "246374320",
            "telephone_number": "276-963-3606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "ANNIE",
        "middle_name": "CATHERINE",
        "name_prefix": "Miss",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-24",
        "last_updated": "2023-04-24",
        "certification_date": "2023-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VA",
            "license": "0701012434",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Audra Beth Brown, LPC
• Amy Lynn Burks, FNP
• Kimberly Dawn Carroll, MA
• Valerie Jean Christian, OD
• Claypool Hill Pharmacy
• Claypool Hill Pharmacy
• Clinch Professional Physician Services LLC
• Cline Eyecare, Inc
• Kerry Keith Cline, O.D.

• All providers in Pounding Mill, VA
• Mental Health Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.